The Spanish government has approved a new royal decree that restores fully universal access to public healthcare in the country. In future, people without legal residency status will also be entitled to medical treatment within the state healthcare system. With the reform, Madrid aims to remove bureaucratic barriers and ensure that everyone living in Spain can receive medical care.
Spain Press Editorial Team
Immediate access to medical care
At the heart of the new regulation is a simplified procedure: anyone living in Spain who does not have other health insurance can now submit a simple declaration and gain immediate access to public healthcare. A provisional document is issued at the time of application, allowing patients to receive medical services straight away.
The authorities then have up to three months to review the application. If no decision is made within this period, access is automatically granted. This is intended to prevent long waiting times, which previously discouraged many people from seeking medical care.
End of regional disparities
An important aspect of the decree is the standardisation of rules across all of Spain. In the past, access to healthcare for undocumented migrants often depended on the autonomous region in which they lived. The new regulation now requires all regions to provide the same level of access.
This aims to eliminate territorial disparities that have existed since the austerity measures following the financial crisis. The government emphasises that healthcare provision should henceforth be delivered “under conditions of equality and fairness.”
Particularly protected groups
Certain groups continue to receive special protection and access to medical care regardless of their residency status. These include, in particular:
-
Minors
-
Pregnant women
-
Victims of gender-based violence
-
Victims of human trafficking
These individuals are to be given priority treatment and faster access to medical services.
Return to the principle of universal healthcare
With the new decree, Spain is effectively returning to the model that existed over a decade ago. In 2012, the then-conservative government significantly restricted access for people without residency status, drawing criticism from medical organisations and human rights groups.
The current reform largely removes these restrictions and restores the principle that the state healthcare system is open to everyone living in Spain.
Part of a broader migration policy
The decision is also linked to other migration policy measures by the government. Madrid had previously announced plans to regularise the residency status of hundreds of thousands of undocumented migrants, allowing them to work legally. Estimates suggest that around 500,000 people could benefit from this process.
According to the government, early access to primary healthcare can also reduce costs in the long term, as illnesses are detected sooner and expensive emergency treatments are avoided.
Political debate
The reform has also sparked political debate. While supporters view the move as an important step for protecting public health and promoting social integration, critics warn of a potential additional burden on the healthcare system.
Regardless of the political debate, the decree marks a significant shift in Spanish healthcare policy: the country is fully restoring universal access to public healthcare, regardless of patients’ residency status.
